[Intestinal mechanical sutures: macroscopic and histological aspects (author's transl)]

Abstract

The authors studied healing in digestive sutures carried out using automatic clips in the Dog. The mechanical conditions of the suture and in particular the absence of crushing are responsible for an almost perfect scar healing by first intention. The absence of ischemic necrosis remains the main factor differentiating these sutures from manual sutures where necrosis is constant, whether due to repeated trauma from forceps or ischemia due to tightening the threads, and above all, constant inclusion of the mucosa within the scar. The use of non-ischemic sutures explains undoubtedly the low incidence of fistulas, but explains, on the contrary, the large number of cases which bleed from the divided margins of the sutured or anastomosed layers; in rare cases, severe bleeding requires reoperation. These sutures are everted sutures causing a significant number of adhesions. We did not find any significant difference in the healing of inverted or everted sutures from the 15th day onwards.